Individual
OMAR IBRAHEEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1010 DOVER LN, AURORA, IL 60504-5996
(208) 293-2435
Mailing address
1010 DOVER LN, AURORA, IL 60504-5996
(208) 293-2435
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
I16564092280
IL
Other
Enumeration date
05/02/2025
Last updated
05/02/2025
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